Mastoiditis Treatment

The mastoid bone is located just behind the ear and has several air cavities that help in protecting the delicate structures of the ear, regulate the ear pressure, and protect the temporal bone during trauma.
These air cavities get infected and filled with discharge during mastoiditis.

Types:

The different types of mastoiditis are:

1. Chronic mastoiditis: This type of infection lasts for a month or more, or comes back following antibiotic treatment.
2. Acute mastoiditis: This type of infection usually goes away within a month of treatment and does not return again.

Causes:

Mastoiditis may occur due to the following conditions:

1. Acute otitis media (middle ear infections)
2. Cholesteatoma (a benign or non-cancerous cyst that invaded the middle ear and mastoid causing deterioration of the ear canal and permanent loss of hearing)

Risk factors:
The risk of developing mastoiditis is more in the following cases:

• Children are more likely to get mastoiditis than adults
• Age less than two years
• Immunocompromised patients
• Abnormal or incomplete air cells formation
• Recurrent otitis media

Symptoms

The symptoms associated with mastoiditis are:

1. Headache
2. Loss of hearing
3. Fever
4. Swelling, redness, and tenderness behind the ear
5. Drainage from the ear
6. Drooping and bulging of the ear

Diagnosis

1. Physical examination: The doctor will evaluate the physical health of the patient. The doctor will also check for symptoms like posterior ear tenderness, swelling, or redness behind the ear.
2. Ear examination using an otoscope: The doctor will look through the ear canal by using an otoscope.
3. Blood tests: Tests like complete blood count (CBC) and white blood cell (WBC) count help in confirming the presence of an infection.
4. Ear culture: If there is pus coming out from the ears of a child, the doctor will check for bacterial infections.
5. X-ray of the skull: The image of the inside of the head can be obtained using an x-ray.
6. CT scan of the ear and head: This test uses x-rays and a computer to create detailed pictures of the inside of the ear and the skull.
7. MRI scan of the ear and head: This is a type of imaging test that uses strong magnetic fields and radio waves to create detailed images of the inside of the ear and the skull.
8. Spinal tap or lumbar puncture: If the doctor confirms the diagnosis of mastoiditis, a lumbar puncture procedure may be performed to check if the infection has spread to the spinal column.

Treatment

Non-surgical treatment: It can be performed using the following:
Antibiotics: Antibiotic injections may be given intravenously (injected into the vein) followed by oral antibiotics to treat mastoiditis.

Surgical treatment: If antibiotics fail to treat infection, the following surgeries may be recommended to treat mastoiditis:

1. Myringotomy: A small hole is made by the surgeon in the eardrum to drain the fluid from the middle ear and relieve pressure. A small tube is then placed into the middle ear to prevent the hole from closing and allow continued drainage. This tube usually falls out on its own after six to twelve months.
2. Mastoidectomy: The infected part of the child’s mastoid bone is removed through an incision made behind the ear in this type of surgery.

Risks

Untreated mastoiditis may lead to the following complications:

• Vision changes
• Vertigo
• Dizziness
• Mastoid bone destruction
• Facial paralysis
• Epidural abscess (infection inside the skull or near the spine)
• Meningitis (inflammation of the brain and spinal cord membranes due to an infection)
• Partial or total loss of hearing
• Sepsis (spread of infection throughout the body)
• The complications associated with surgery performed to treat mastoiditis may include the following:
• Injury to the facial nerve
• Hearing loss
• Infection
• Bleeding 
• Dizziness
• Tinnitus
• Alterations in taste
• Cerebrospinal fluid (the fluid that surrounds the brain and the spinal cord) leakage
• Need for revision surgery

After Procedure

The following are the post-procedure steps following surgery for mastoiditis treatment:

• The patient needs to take one or two weeks off from school or work after surgery.
• It is normal to experience an altered taste in the mouth for a few days after surgery.
• It is normal to have some jaw swelling after surgery. This swelling usually disappears on its own in a few days.
• It is normal to have some ear pain and discomfort after the procedure. The doctor will prescribe pain-relieving medications for the same.
• The doctor may prescribe antibiotic medications to prevent infection after surgery.
• Follow all the instructions of your doctor for a rapid and smooth recovery.

Home remedies:

The following home remedies are useful following mastoiditis treatment by surgery:

• Avoid keeping your mouth open while sneezing or coughing.
• Avoid exercising for a few months after the surgery.
• Avoid swimming during the recovery period.
• Place some cotton in the ears before taking a bath to prevent any water from entering the ears.
• Keep your head in an elevated position while sleeping.
• Avoid moving your head excessively during the recovery period.
• Avoid lifting heavy objects and strenuous activities during the recovery period.

Prevention:

The following tips can help in avoiding middle ear infections that may lead to mastoiditis:

• Quit smoking
• Limit the use of pacifiers for babies
• Prevent getting a cold
• Control allergies
• Use preventive antibiotics to remove infection
• Cover your mouth while coughing or sneezing
• Wash your hands frequently
• Take the pneumococcal vaccine

Cost of mastoiditis treatment in India-

The cost of mastoiditis treatment using medications is between INR 2,000 to INR 3,000.
The cost of surgery for mastoiditis treatment in Mumbai is between INR 55,000 to INR 80,000.
The cost of surgery for mastoiditis treatment in Delhi is between INR 50,000 to INR 75,000.
The cost of surgery for mastoiditis treatment in Bangalore is between INR 50,000 to INR 75,000.
The cost of surgery for mastoiditis treatment in Chennai is between INR 45,000 to INR 70,000.